New BPHC Report Highlights Persistent Racial Inequities in Maternal Health

BOSTON – October 5, 2023 – The Boston Public Health Commission (BPHC) today published the Maternal and Infant Health Report, the latest report in the Health of Boston series. The report details the latest trends for birth outcomes (birth rates, teen birth rates, low birthweight births, preterm births) and infant deaths among Boston residents and provides data to inform stakeholders with actionable information on the maternal experience of Boston residents.

The report found several concerning racial inequities in maternal health outcomes:

In Boston, Black residents experience highest rates of infant mortality, preterm births, and low birth weight.

The rate of infant mortality among Black infants in Boston (9.7 deaths per 1,000 live births) was more than twice the citywide average (4.6 deaths per 1,000 live births) and more than three times the rate for white infants (3.2 deaths per 1,000 live births) in 2021.
- From 2017-2021, Black infants had the highest rate of infant mortality among all racial and ethnic groups.
The percentage of low birthweight births among Black infants (13.4%) was more than twice the percentage for white infants (6.2%) in 2021.
- Citywide average for low birthweight births was 8.4% in 2021.
In 2021, the percentage of preterm births for Black mothers (13.8%) was nearly twice the rate of white mothers (7.1%).

Neighborhoods with higher concentrations of Black residents experienced significantly worse maternal health outcomes than others.

Hyde Park had the highest rate of infant mortality of any Boston neighborhood (7.8 deaths per 1,000 live births) from 2012-2021.
- The bordering neighborhood of Roslindale had the lowest rate of infant mortality in Boston (2.4 deaths per 1,000 live births).
- For context: 48.7% of Hyde Park residents are Black. The median income is $81,849 and 14.4% of residents have a bachelor’s degree. By comparison, in Roslindale, 25% of residents are Black. The median income is $93,601 and 17.4% of residents have a bachelor’s degree.
Mattapan had the highest percentage of low birthweight births (11.8%) for 2019, 2020, and 2021 combined. Dorchester (02121, 02125) had the second highest percentage at 11.3%.
- For context: 78.2% of Mattapan residents are Black. The median income of $61,180 and 8.2% of residents have a bachelor’s degree.
Mattapan (12.7%) and Dorchester (11.1% 02121, 02125 and 10.7% 02122, 02124) had the highest percentage of preterm births in Boston for 2019, 2020, and 2021 combined.

Although many of our Black residents live a few short miles from some of the best hospitals and providers in the world, much like the rest of the country, the city of Boston and the state are in a Black maternal health crisis. Data from the Massachusetts Department of Public Health (MDPH) indicate that Black women in Massachusetts are 1.9 times more likely to die during pregnancy or within one-year postpartum compared to white women. These findings underscore the need for urgency and greater investment and availability of resources that address underlying social determinants of health and improve access to pregnancy and early childhood care.

“As the nation’s healthcare hub, Boston has a responsibility to lead by tackling the social determinants of health that unjustly harm our residents and disproportionately impact BIPOC communities,” said Mayor Michelle Wu. “The Maternal and Infant Health report’s findings are alarming, and in our charge to make Boston the best city to raise a family, we will work with our Boston community and healthcare experts to find solutions that empower mothers and families of all backgrounds."

Racism, discrimination and implicit bias within the health care system negatively influence pregnancy outcomes among Black individuals. Social determinants of health, the non-medical factors that influence health outcomes like housing, income, food security, and neighborhood safety, significantly contribute to persistent inequities. As the report demonstrates, these determinants of health have led to troubling racial health inequities in birth outcomes.

“The findings of our Maternal and Child Health of Boston Report are a call to action for our city,” said Dr. Bisola Ojikutu, Commissioner of Public Health and Executive Director of the Boston Public Health Commission. “These stark racial inequities in infant mortality and other birth outcomes cannot continue to exist. Boston is one of the few cities with the public health and health care infrastructure necessary to address these inequities, and we will commit our resources to doing so.”

BPHC will use these findings to work with providers, community health centers, researchers, legislators, and community leaders to develop policies and enhance current programming that address the root causes of racial inequities in birth outcomes. BPHC is hosting a series of community meetings to identify new, community-driven strategies to advance health equity throughout Boston.

BPHC and the City of Boston have several programs in place to improve the overall health and well-being of the city, including maternal and child health. Initiatives and programs such as Healthy Baby Healthy Child, Boston Healthy Start Initiative, Love for Latch, Father Friendly, and Welcome Family Program for new and expecting parents provide support for expecting mothers and families and their babies. Since 2020, the Healthy Baby Health Child program and Boston Healthy Start Initiative have served nearly 3,000 women in Boston.

In addition to its existing programming, BPHC was recently awarded a $4.7 million grant from the Department of Health and Human Services (HHS) to establish the Boston Healthy Families Community-Based Perinatal Health Project to increase access to doula care, which is proven to support families and improve birth outcomes. Under this project, BPHC will connect pregnant families to doula care, train and certify 25 new doulas from underserved communities, educate and train an additional 50 practicing doulas annually, and inform providers and the public about the benefits of doula care.

For more information on BPHC programming and supports for pregnant women and families, visit boston.gov/bphc or call the Mayor’s Health Line at 617-534-5050.

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